Online Home Mortgage Service

Be sure to check out helpful information on Processing Your Loan Application!

Please fill out the information in this form to apply for a home loan. The form may be mailed to us at 14850 Montfort, Suite 290, Dallas, TX 75240 or faxed to us at 972/991-2272. All responses are strictly confidential. Thank you for using our online loan application service!
Basic Data & Residence History

Previous Address(If less than two years)

Co-Borrower Information

Loan Objective


If purchase loan, has property been located?

Sales Price:  

Employment Data - Primary Borrower


Previous Employer: (If less than two years)


Employment Data - Co-Borrower


Financial Data

Approximate Monthly Debts:

Derogatory Credit:

Explanation of any incorrect information you are aware exists in your credit files:


Please provide us with any helpful information:

Disclosure Agreement

Yes I read and state to all consumer reporting agencies and to all creditors of the undersigned please be advised that the undersigned, and each of them, has made application for PRE-QUALIFICATION with CUSTOM MORTGAGE CORPORATION requesting a potential extension of credit to the undersigned. Therefore, the undersigned, and each of them, hereby authorizes you to provide credit report and/or a disclosure to Lender or any agent or balance. The undersigned also authorizes you to disclose your credit experiences with the undersigned to Lender or related third parties.

I agree.

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